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E48 - Doctor Nurse – Lynda Balneaves

Rather than measure the wing span of mosquitoes, Dr. Lynda Balneaves RN became a nurse. Her story begins with recognizing a love for people and for travel. Her academic journey, of supporting people and health care providers with engaging in shared decision-making related to complementary and integrative health care, includes some of Canada’s earliest cannabis research. The scholastic chronicles, of this Doctor Nurse, speaks to how we can never truly plan our life path, but we do have the power to be properly prepared for opportunity. This episode will guide care givers in their practice responsibilities with cannabis, while increasing the expectations of those who receive care through it.

Episode Transcript

Trevor: So, Kirk, way back at the beginning, we were trying to figure out, you know, who we should interview for this thing that we thought we were going to do called the podcast. And you waved an article out and you said, hey, in this nursing magazine, they've got someone there's a.

Kirk: Doctor, nurse.

Trevor: There's a doctor nurse.

Kirk: That she studies cannabis. Yeah. So this goes back, man. This goes back to a storyboard item three years ago. Right. We're talking about how we're pulling items off the shelf again and we're putting it together and we're producing Reefer Medness - The Podcast.

Trevor: Yeah. So maybe I should say I'm Trevor Shewfelt, I'm the pharmacist.

Kirk: And I'm Kirk Nyquist, I'm the nurse. I'm the guy who's the fanboy of the celebrities that we've been interviewing lately. I got so tired of talking to celebrities.

Trevor: It's too much dessert, man.

Kirk: It was I need to get.

Trevor: We're going to have some broccoli.  Now broccoli can taste really good and this is good tasting broccoli you got us.

Kirk: Yes. Broccoli, Dr. Balneaves is broccoli today.

Trevor: We mean that in the nicest possible way Linda.

Kirk: We have an academic today, Trevor, I'm bringing you an academic. And we're going back to our roots to this podcast, Dr. Linda Balneaves. She is a researcher out of the University of Manitoba. You are very correct. I, I picked up on her very early. She was she was quoted in the Nursing National Nursing Magazine almost three years ago about being a cannabis nurse, finally, finally got a hold of her and chatted with her. And I've had a couple of conversations with her. A really nice lady.

Trevor: A very smart lady.

Kirk: Very smart lady. You know, it's really interesting, though. Everything happens for a reason. You know, I think getting her at this stage of our podcast, I think she's going to be about episode forty-eight or something like that, getting her here now as opposed to getting her for our first five, which is what I really wanted her for back then. I think I feel more prepared to talk to her than I would have two and a half years ago.

Trevor: Yeah, and she's just fits in nicely with some of the other people we've talked to, even, you know, just simple things like when we back when we talked to Dr. Ian Mitchell and he was talking about how it's become a little harder to do cannabis research since legalization, which, you know, kind of blew my mind. But she's saying some of the same things that would have been kind of meaningless way back at the beginning.

Kirk: Well, exactly. And the other thing that's interesting is that, again, as we were talking and as you were listening to the to the tape as well, she crosses over other people we've talked to, like we've talked to compassion clubs out on the West Coast. We've talked to other advocates that still on the shelf that we need to get to that. So, I think I think we all know the same people.

Trevor: The cannabis community is small and very interconnected.

Kirk: Yeah. So this is how I view this this conversation I'm having now. Some of our listeners are probably going to say, oh, it's an academic. This is the one I'm going to not listen to. But what I also like about this episode, talking to Dr...

Trevor: And they shouldn't do that.

Kirk: No, of course not. No, but this is me enticing them, Trevor. Don't turn off the podcast. This is going to be a little bit nursey. So, I really think nurses that listen to this podcast could use it for Con Ed because she's going to give us as nurses, as health professionals, some insight on how we can be canna-knowledge and Canna-curious and maybe incorporate cannabis into our practice. We go to that. But ultimately, for those nonmedical people that do listen to our show, it's a story of a day in a life where a career and a life of a nurse. And this is what I like about this conversation I have with Linda, is that we're basically getting to a point where we're having a conversation. And this is why I said earlier, I don't think I would have been ready to have a conversation with her that I had today back in the first five. I think I would have tried to squeeze a lot of knowledge out of her in a different way. And maybe it's my sophistication or my comfort level with understanding cannabis and having maybe having a better understanding of how cannabis fits into my practice after these three years of this podcast. So everything happens for a reason. This interview is a cool interview for me as a nurse to learn from a doctor, a researcher nurse. So nurses, you're going to like this one, everyone else. It's also a good human-interest story.

Trevor: Oh, no, she's a great story. Let's let's get to Linda.

Linda: Sure, my name's Linda Balneaves, I'm an associate professor in nursing at the University of Manitoba and I'm also the deputy director of the Canadian Consortium for the Investigation of Cannabinoids CCRC.  So I got into nursing just after I completed a science degree at the University of Manitoba. And I was really looking for a position that I could still engage in research but have a more kind of practical application. I had been doing acid rain research and I was measuring the wingspan of mosquitoes. And I just didn't see myself having that as a full-time career for the rest of my life. I would love working with people. And I also love to travel. And just nursing seemed to be a very diverse field that would allow me to be up close and personal with people, understand what their life experiences are with health and well-being, and also give me that chance to hopefully travel the world, which I very I've been very fortunate to do with my career. In terms of cannabis. You know, backing up a bit, my my main research focus has been on supporting people and health care providers and in engaging in shared decision making related to complementary and integrative health care.  So that's everything like natural health products, acupuncture, going to a natural path, engaging in mindfulness, doing a yoga class. So, I've always been really interested in people that decide to use something that perhaps isn't really considered mainstream or they try to add something onto their conventional health care plan. And so, I've been very active, you know, since I began my master's actually in exploring complementary in integrative medicine. And so, if you if you flash I had about 10 years. I was at the University of British Columbia and I was literally standing in the hallway and I heard someone yell out, go talk to her. She might actually be interested in helping you. And it was an individual that was working at a local cannabis dispensary, had a masters, was interested in research and was trying to find anyone at the university that would be willing to work with her in developing a research program and helping the dispensary actually conduct research on their patients and individuals that were accessing cannabis for therapeutic reasons. And I guess because of my research in complementary medicine, in natural health products, I would argue, you know, focusing on people using stigmatized forms of medicine, they thought I might be a good fit for that individual. And I was really intrigued about what they wanted to do. And that started this off in developing what was called the hemp project, which was the health effects of medical cannabis. And that program really opened my eyes to the potential of cannabis as a therapeutic and also some of the patients experiences and their struggles in being respected in their choice, as well as being able to gain access to a legal supply. And so, you know, since that time, I've kind of dabbled in the area of cannabis and more recently have really started to focus a lot of my attention, energy and looking at the role of cannabis health policies around cannabis and continuing to explore patients experiences and accessing it.

Kirk: OK. So that gives us some timelines to legal cannabis. Legal. Medical cannabis. Cannabis was probably six years, seven years old by then.

Linda: It had under the current scheme, we still have the MMR, they are, you know, which had a very limited supply of medical cannabis that was being grown in Manitoba and there was a lot of reservations about the quality of that product. And as a consequence, we had, particularly in British Columbia, we had a lot of cannabis existing in that gray source and in the community medical dispensaries that in BC were being left alone by law enforcement. And we're able to really address some of the really stigmatized populations in that province, people living with HIV AIDS, people living with advanced cancer, people that were terminally ill. People have mental illness, that dispensary is really a safe place for people to access medical cannabis without having to go through the very lengthy process of trying to convince their health care provider, mainly their physicians, that cannabis could be useful to them and to actually authorized their use through the legal system.

Kirk: You know, Trevor, I am going a break here for a minute. When I when I was researching Linda, I didn't obviously didn't get deep enough because this whole part of her history of British Columbia, I didn't know that. And I found it fascinating. And actually, I found myself listening so much to her that I forgot my next question. A lot of the research she was doing at the time was helping the compassion clubs and the dispensaries in the Lower Mainland at the time. And I think that's all now cannabis folklore that that era of time, it's only about 10 years ago.

Trevor: Yeah, it seems like ancient history, though, you know, pre-legalization. And what were those crazy people doing in Vancouver, giving business licenses to illegal operations and.

Kirk: Yeah, well, she was part of that now. Now, careful with how you say legal and illegal. It was a medical cannabis was legal.

Trevor: It was. But they you didn't well, call it gray because at the very least, I could walk in there and say, you know, I've got a headache, man. And I could probably bought cannabis, which probably wasn't what the medical good or bad that I don't think that's what the medical licensing was intending.

Kirk: Well, if I understand the process of the day, you did have to have a medical certificate to go into one of these dispensaries. So there was a gate guard, our gate keeper, a gate keeper. Right. So you're correct how that may have been misused. Uh, that's for politics and other brains or another episode. But what I liked about this one was that how she was connected to that. So she goes back. She goes back in time, one of the earliest researches of cannabis. That was a cool part of this conversation. So she goes into this. She goes in and talks about working with the dispensaries.

Linda:  This was actually a person that was working employed at a community dispensary in British Columbia. That was really keen and trying to partner with a university colleague. And actually, applying for funding to conduct a survey of their clients that were coming into the dispensary. So, it really was a community partner that was reaching out to the university saying, you know, we'd love to do this project. We want to partner with the university to do it. And hopefully we can seek some external, you know, federal funding to actually conduct this research on this one.

Linda: So we were really focused and just understanding from the patient perspective what the health effects were of medical cannabis. So, people using cannabis in a therapeutic way and really trying to understand, you know, kind of from that first voice from the patient of, you know, what worked well using cannabis, what was problematic and using cannabis. We also secondarily were interested in just their access experience. So, what was it like to try to gain access to the legal system? Why were they finding themselves at a community dispensary instead? You know, what was the value of cannabis, not just for their health condition, but for their overall life, quality of life and well-being. So we were really kind of just interested in hearing from the patients themselves of their overall experience of using medical cannabis, how they found it was working, what they saw as being the major side effects or risks attached to it, and really kind of what their hopes were for the future. You know, and what we found overwhelmingly were that patients saw the greatest risk was really around the potential interaction with law enforcement. They did not perceive there to be a great many negative health effects attached to their use of medical cannabis. In fact, many people said that using medical cannabis allowed me to actually have a life. Again, we were talking to some individuals that were living with HIV AIDS. They were just starting to get into using the antiretrovirals that we see nowadays. Many of them come with an enormous amount of side effects. A lot of people were living with chronic pain and really cannabis allowed them to enjoy their life for some individual, allowed them to get back to work. But for many of them, they really, really struggled with being having to have interactions with law enforcement if they were seen to be using cannabis in public. They had, you know, interactions with housing authorities for people that are living on disability in terms of being reported for using cannabis without their legal documents. They were perceived as being used using an illegal substance, which sometimes could threaten, you know, not only their housing but also their employment. It just it was quite profound to hear the stories. We had individuals that were moving from their communities to Vancouver in order to be able to gain access to cannabis, which they were not able to do so within their home community. You know, hearing people talk about the sensors that they've received from their own family and friends about their cannabis use and having to, you know, actually end friendships or relationships with family members because of their cannabis use. So, it was it was quite profound. We also heard a lot from patients about the amount of time and energy they had to put into trying to convince their health professionals about using cannabis legally to actually gain that documentation that would protect them from law enforcement. And, you know, for some patients, it took over a year documenting their symptoms, showing improvement to be able to convince their physicians to actually authorize their use of cannabis legally for medical purposes.

Kirk: That, you know, that that research sounds like it really had impact on you as an individual.

Linda: It did, because, you know, we often we're dealing with patients that had tried numerous pharmaceutical therapies that were now I've found it to be effective or they were they came with them. A lot of negative health effects and a lot of side effects. And it was quite striking to hear how patients were saying, you know, that my experience, you know, is that I'm feeling much better. My health is better. I'm actually removing myself from very costly, risky pharmaceuticals such as opioids. And I'm still not being supported in this choice, one that is actually been deemed to be legal in this country. So I think to me, that whole sense of using a stigmatized medicine, the barriers that these individuals, some that were very, very sick were experiencing and the amount of stress that it posed in their lives, it didn't really strike me, you know, not only as a nurse, but just, you know, as someone that's, you know, as a Canadian to just see the type of barrier that people were experiencing in something that was legally available.  So it ended in 2010. And we've had two major papers published from that. So, I'm happy to share that with you. But it was. It was it was one of one of the first studies in Canada that really, we're trying to give voice to patients and their experiences and wasn't so much, you know, focused on let's do a clinical trial of nabilone and see if it works.  And I think it provides an important context around, you know, where medical cannabis was at that time. And then, you know, moving ahead forward in terms of where we are at now, as well as the research that remains to be done in terms of efficacy and safety.

Kirk: So let's Segway right into it. I know I could do a whole episode on that one study and my brain is telling me I got to move forward.  So you go from UBC to University of Manitoba and here you are in Manitoba. What research you currently doing with cannabis specifically or any other research you'd like to share with us?

Linda: Sure. So, my you know, in that time in between UBC and I have a brief stint at U of Toronto and then, you know, being here, I've shifted focus a little bit because, you know, in that hemp study, what really came out is that there were some real gaps in knowledge around health professionals. And so, in working with colleagues like Dr. Mark Ware, where we actually conducted a survey with nurse practitioners to just gain a real sense of what their information needs and what their attitudes were related to medical cannabis. This also, you know, is derived from my experience working with the Canadian Nursing Association that has actually taken a very proactive role in looking at cannabis and its role in nursing care. And so, we did a national survey of nurse practitioners just to get a real sense of whether they had gaps in knowledge as well as what their attitudes were in terms of their own role in authorizing medical cannabis. Because since 2001, nurse practitioners have had that ability federally, but it has not necessarily rolled out across the country. And it's only more recently that we've seen the majority of associations, nursing associations across the country approve NPs authorization of medical cannabis. So, we did published a study that looked at those gaps in knowledge. And not surprisingly, a lot of nurses felt that they still needed to better understand the endocannabinoid system. They need to better understand the effects of medical cannabis as well as side effects. And they still needed to understand what the actual federal legislation was related to medical cannabis provision and distribution in Canada. Well, we also found is that meeting many nurse practitioners felt that they could have a role as a primary care provider in authorizing cannabis, but they needed more education on it.

Kirk: Well, it's interesting that you say this, because when we started this process, I'm at the time I'm a northern nurse, so I work for the federal government. So, when I started this when I started the podcast with Trever, I came out and that, you know, conflict of interest. I worked for Health Canada at the time. I would do a podcast on cannabis. And I sent out a conflict documentation because I wanted to make sure I was covered for my employer’s perspective. I heard nothing back. I phoned the College of Nurses in Manitoba. They really didn't have much to say except be careful if you're talking about cannabis because, it's illegal. I phoned the Association of Nurses in Manitoba. I got sort of dead air there. They told me to phone the Canadian Nursing Productive Society, talk to a lawyer. I had two interviews with the lawyer to the point at the end of the interview, she said, well, here are my recommendations. And I said, well, out of those four, I meet three of them. And the fourth one, you want me to take a journal, go to school and be a journalist? Well, my wife is a journalist, so I said I actually ticked off all four boxes. She said to me. Well, I guess you would. Then why did you phone me? I said, I'm trying to. I'm trying to limit liability or what should I do? Right. I'm going to talk about cannabis as a nurse. I have to be careful. My buddy's a pharmacist and the Pharmacist Association of Manitoba has pretty much said thou shall not. So, I preface my next question with that in mind. You're a registered nurse. You work in the health care field. How does cannabis limit what you do or actually accentuate what you do, how to help? What safeguards did you put in place when you work with cannabis?

Linda: You know, for me, I know I've really been privileging the patient voice, so I feel that, you know, my research training, you know, being a registered nurse, I don't feel I need any protection around just simply translating what patients are telling us to the larger scientific and public communities. In terms of when I do presentations, which I've done know, innumerable presentations to various audiences ranging from, you know, adult education, you know, people in their 20s that I've gone back to school to, you know, immigrant groups, to, you know, colleges of nurses. I guess I always preface that I am presenting the evidence as I currently see it, you know, and I use reliable sources of evidence, you know, journals that are peer reviewed and published and respected, you know, publications I use, you know, systematic reviews, you know, that are available, you know, national international reports that have been peer reviewed and published. You know, when I'm sharing evidence, I'm really, you know, sharing and translating what is currently out there. I'm just, you know, basically summarizing it for individuals that don't have the time or don't have the necessary resources to do that, their skills. I you know, to me, because I've worked in the field of complementary integrative medicine for so many years. I guess I'm quite familiar with our ethics and our scopes of practice that, you know, if you're going to talk about a therapy, if you're going to be summarizing the evidence, it's always important to preface, your discussion with I'm not making medical recommendations. I will not be answering specific, you know, questions around people's personal health because I do not have access to your health record to be able to make any recommendations. I can direct you towards resources that you could, you know, hopefully seek that information. And I always end by telling people that if you're thinking of using cannabis, you have questions about it.  Always consult with your health care team and get back to me. Yeah. Those kinds of disclosures.  But at the same time, I really rally a rail story is the right word rail against individuals that say, well, you know, we don't have sufficient evidence. Right. Be it cannabis, be it, you know, Dung Cly, you know, a Chinese herb. You know, I always say that, you know, just telling a patient that there is no evidence doesn't help them in their decision making.  We have some aspects, you know, some research that's been conducted.  And it's important that we tell people what we currently understand and the limits around what we currently understand, where there's gaps in knowledge. And that doesn't necessarily mean that a therapy does or does not work. It means we don't know at this time. And then you need to talk to patients about level of risk that they're comfortable and living with in terms of that unknown. You know, we know a lot about side effects or around something like cannabis. That information needs to be shared. We know a lot about safe use and lowering your risk associated with cannabis use. That information can definitely be shared. So as a registered nurse, I still feel like I'm in a pretty good place. And I also know the lawyers really well. The CNPS has come out with, you know, they've kind of revised their first statement around cannabis. And I really have come out with something that's a lot more nuanced, which actually reflects, I think, our full scope of practice in nursing related to cannabis.

Kirk You're a researcher. You're also a nurse. And this sort of combines two questions. What advice would you give a frontline nurse and what do you think best practice are with cannabis. That's a huge question. Take it where you want.

Linda: It's a huge it's a huge question. You know, I think for me, as you know, I think it's important that nurses right off the bat understand the endocannabinoid system. And we have a long way to go to getting that into our curriculum at all levels, be it undergrad graduate. And I think, you know, there there's growing number of resources. CCIC has resources online and we'll be hopefully launching in the near future a new resource for health professionals interested in medical cannabis. There's other online programs out there and I really encourage nurses to seek out those resources and update your knowledge related to the endocannabinoid system, because it will help you in understanding the literature that's out there and answering some of the questions that patients may have and better understanding the potential of cannabis.  You know, I really encourage health professionals, you know, to seek out those credible information resources that are out there. You know, the summaries of current evidence, particularly if you're working in specific fields. So, if you're in a field of oncology, there's a lot of articles out there, you know, discussion articles by leaders like, you know, Dr. Donald Abrams from UCSF, where you can actually, you know, get that document review what the current understanding is so that you can have informed conversations with your patients. You know, I think for the bedside point of care nurse, you know, bachelor prepared. I think it's within all of our scope of practices to be able support informed decision making. And I think it's important that we're able to listen to patients’ questions around cannabis. Answer some of very basic questions around safe use, around the different types of products that are out there to share some of the current evidence that we understand, particularly around things like chronic pain, nausea and vomiting, you know, where we have a fair amount of evidence around cannabinoids in those health conditions. I think it's always good to know someone you can refer to in terms of, you know, what is, you know, are there some local medical cannabis clinics that are out there where there might be some people that are specializing in this area if they're asking really complex questions that you're not able to answer. I think, you know, whenever someone's talking about any types of substance, be it a pharmaceutical, be it cannabis, be a natural health product. I think it really behooves us to speak about the potential risks, even if they're theoretical risks in terms of potential for medication, you know, product interaction, you know, recommending that they go and speak to their pharmacist to make sure that there is an interaction that they're not aware of. They're living with a health condition like heart disease. We should be able to say to a patient, you know, if you're going to start using cannabis, particularly high THC, you know, and you have heart disease, is this something you should talk to your specialist about? So, I really see that nurses, you know, could be developing some best practices related to, you know, safe use of medical cannabis, informed use of medical cannabis, and be knowledgeable about when it's time to to refer an individual to someone that has more knowledge. And the great thing is, is that the Canadian Nursing Association, you know, has been working towards developing some best practices. Right now, it's specific to the area of non-medical cannabis use, recreational use. But I think there will be some lessons from those best practices that can be applied when we're talking to anyone about using cannabis, even if it is medical cannabis, to just be able to inform people about the potential risks attached to it. So, I don't know if I caught all of your questions. There is another point you need me to clarify. Just let me know.

Kirk: I know I was following every word you said and you pretty much validated my thoughts. And this is one of the reasons why Trevor and I started this podcast is we weren't naïve to cannabis. I mean, my demographic, I could again speak to cannabis. But did I know the research? Did I did. I was able to, as a health professional, be knowledgeable. We started the podcast. And everything you just said in the last four minutes there was on our list and we started this, you know, best practices, what's out there, who's saying what, who's doing the research? As you get to know our podcast, we just did a whole episode on gabapentin and I got the bash Gabapentin because the research is faulty on gabapentin. And yet everyone says that, you know, cannabis has no research. Well, that our speaker, our guest basically said to us is as there's as much evidence on cannabis being used for fibromyalgia as there is gabapentin. And I was like, okay, so we do have research at work. So, is it an alternative or is it is? Should it be best practice to use cannabis instead of gabapentin, right? So, these are the questions we're asking ourselves. Here's a question for the future five years from now, where do you see your research going? Where do you see cannabis? Where do you see the alternative care? Bedside care. Five years from now, how is your research changing?

Linda: Well, we've you know, we currently have a grant. My area has been oncology for many years and we currently have a grant under review that we'll hear about hopefully next week.  That's looking at the role of cannabis in managing the symptoms and side effects of cancer related treatment. I would love to be able to say in five or six years that we're coming near the end of a clinical trial focusing on Taxin acute pain syndrome, using a cannabis product that has, you know, been able to show that cannabis is a reliable, credible alternative to using other pain medications like opioids. So, you know, in the future, I would love to be developing a research program along with my colleagues at the Canadian Cancer Trials Group that's really focusing on cannabinoids and seeing what role they could potentially have in treating and managing the symptoms of people living with cancer. That's one vision. The other vision is to really see nurse practitioners, you know, practicing to their full scope of practice and being able to take advantage of the federal authorization and being able to actually work with patients, you know, in making decisions around using medical cannabis for conditions other than cancer. I would love us to see similar trials happening. And, you know, osteoarthritis, rheumatoid arthritis. I would love to see these trials happening with people living with Crohn's disease, people living with Parkinson's. I think that there's a whole host of health conditions that we need to have research on the potential of, you know, whole plant cannabis-based products. And, you know, I would love to see, you know, beyond those six years looking ten and fifteen years in the future, that we have cannabinoid-based medicines as being an evidence-based alternative to some of the many expensive pharmaceuticals that we have that come with their own side effects. So that's that would be, to me, a wonderful vision in the future. I would also love to see us having more access to cannabis research, be it through additional funding, be it through a more streamlined process of accessing product and getting clinical trials on cannabis approved in this country.

Kirk: So we're going to break in again. Yeah.

Trevor: Research.

Kirk: Research, a recurring theme.

Trevor: It is. And so we've talked for ever, especially pre legalization won't be great when cannabis is legal and research will be easy. That's much.

Kirk: It's more difficult now for researchers to get research on cannabis than it was before legalization and a lot of it has to do with the fact everyone wants to study the recreational components, you know?

Trevor: Yeah, and Dr. Balneaves needs even mentioning the conversation that that's raised the bar really high for the medical. You know, research is always hard and you've always got to get approval, but the number of approvals he now needs to do, let's say a Parkinson's trial, seems to be far higher than it was pre-legalization, which is strange.

Kirk: Yeah, there's something there's roadblocks. And I don't have enough information to get into it, but we're going to get that interview out. But it is ironic, though, here is a researcher that was really involved with the medicinal side of cannabis in the early days. And now recreational is legal. And what I mean, we had this whole thing, you know, the whole world was going to blow up with recreational legalized cannabis. And what did we see on social media? A couple of days ago that Canada is wrestling with Reefer Mildness. Right. That's the thing. Like our Canadian government is defending the legalization of cannabis by telling everybody that the big madness everyone expected, you know, the whole traffic, car accidents and society is going to stop because reefer madness is going to reap over Canada. Well, it actually turned out to be Reefer Mildness. And one of our one of our listeners suggested we change our name for me from Reefer Medness to Reefer Mildness.

Trevor: Well, we're kind of mild.

Kirk: Well, yeah, depending at what level we are medicated at, but yes. So let's go back to Linda and clean up this conversation with her. She finishes off in the and yeah.

Kirk: Do you find it easier to get approval for cannabis research now post recreational legalization or was it easier prior, easier prior?

Linda: Easier prior? I think with the legalization of recreational cannabis, we are now seeing all cannabis research projects viewed through the lens of recreational use and the concerns around dependency effects on youth. Other side effects. And so, as a consequence, the bars and really raised very, very high. And unfortunately, because there's been so much interest in cannabis recently, I think our approval systems have been just overrun with applications and they don't have the resources to address them in a timely manner. Also, just, you know, it's quite ironic, the number of hoops that you need to jump through in order to gain access to product when you literally could walk down the street and purchase it yourself from a storefront.

Kirk: It's fast. It's fascinating, isn't it?

Linda: It is. It is. And I think, you know, it's kind of you know, we knew that there was going to be a dark side to legalization.  I have presentations that I did two years before legalization, where I actually laid out some of the concerns and fears I had around the negative effect of recreational legalization would have on medical cannabis research. And some of them, unfortunately, have come to pass. But I am hopeful that that's just a blip and even streamlining now, how we apply for a research license, there's a hope that instead of individual researchers having to apply for individual licenses, that each university will hold a research license for cannabis that would greatly streamline the application process and hopefully speed things along.

Kirk: Dr. Balneaves, I got to tell you, I do want to open up and have another chat with users. There is so many parts of things you said I wanted to go into and go down that rabbit hole. We need to talk again.  

Linda : I would love to. That would be great.

Kirk: is there any final words I can give you? Is it. Is there a question that I didn't ask you wanted to talk about today?

Linda: You know, I think I just I guess I would encourage listeners, including those that are skeptic, skeptical around cannabis, that, you know, we have a long way to go. You know, cannabis is not a benign substance, but there's a lot of potential, especially associated with the endocannabinoid system that we really are just beginning to understand. You know, we've only learned about this, you know, major receptor system in our body since the 1960s. That's not a long time to get the basic science research conducted. The mouse models and then move into human trials. And so, I just would encourage everyone to learn more. Stay up to date because the research is changing daily. And to keep an open mind that, you know, cannabis may be an alternative and may address some of the issues that we have with the pharmaceutical industry and pharmaceuticals themselves. And I think that, you know, especially with the opioid epidemic still ongoing, we need to be open to alternatives. And I think, you know, cannabis has some potential. And I would just encourage everyone to stay their judgment until we actually have those trials conducted. And for those that are using cannabis to just, you know, have a dialog with your health care providers and ensure that they're aware of your experiences and that, you know, you share your experiences, because I think that is an important piece of evidence and knowledge that is vital for our point of care practitioners to be aware of.

Trevor: Kind of like getting to the part of my life where, you know, maybe I need a mansiere. This podcast needs support. You have you don't know the mansiere reference to you. Not a Seinfeld guy.

Kirk: I am a Seinfeld guy. I am a visual guy. And that's not a visual visualization I wanted. Tell me about your mansiere.

Trevor: Well, you know, it was it was really Kramers mansiere. But this podcast needs support, if you like, the way what we've been doing and the kind of curious audience we've been reaching, you could support our podcast. How could they do that, Kirk?

Kirk: They can support our podcast by telling other people about it, word of mouth.

Trevor: Or if you have a business that you want to get your message in front of a cannapositive audience, drop us a line at our website or email us at This email address is being protected from spambots. You need JavaScript enabled to view it..

Kirk: Yes. Also, if you like what we do, review us on your platform. Right? We're on blueberry now, right?

Trevor: Yeah, but whatever your, you know, Apple podcast is still probably the best. But any anything that you listen to us on put a review that helps other people find us.

Kirk: Support Reefer Medness - The Podcast. I'm Kirk Nyquist. I'm the nurse and.

Trevor: Trevor Shewfelt I'm the pharmacist. Kirk what are we doing for music this week?

Kirk: We did something completely different.

Trevor: OK.

Kirk: We allowed our guests the opportunity to pick pick the musician this week.

Trevor: All right, let's hear from Linda.

Linda: I would love to hear a song by William Prince, who I'm going to be really fortunate to hear down at the New Orleans Jazz Fest. I think he's the only fellow from Manitoba, from Winnipeg that's actually been given a space at the festival.